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1.
Environ Res ; 251(Pt 2): 118629, 2024 Jun 15.
Article in English | MEDLINE | ID: mdl-38490626

ABSTRACT

BACKGROUND: A knowledge gap exists regarding longitudinal assessment of personal radio-frequency electromagnetic field (RF-EMF) exposures globally. It is unclear how the change in telecommunication technology over the years translates to change in RF-EMF exposure. This study aims to evaluate longitudinal trends of micro-environmental personal RF-EMF exposures in Australia. METHODS: The study utilised baseline (2015-16) and follow-up (2022) data on personal RF-EMF exposure (88 MHz-6 GHz) measured across 18 micro-environments in Melbourne. Simultaneous quantile regression analysis was conducted to compare exposure data distribution percentiles, particularly median (P50), upper extreme value (P99) and overall exposure trends. RF-EMF exposures were compared across six exposure source types: mobile downlink, mobile uplink, broadcast, 5G-New Radio, Others and Total (of the aforementioned sources). Frequency-specific exposures measured at baseline and follow-up were compared. Total exposure across different groups of micro-environment types were also compared. RESULTS: For all micro-environmental data, total (median and P99) exposure levels did not significantly change at follow-up. Overall exposure trend of total exposure increased at follow-up. Mobile downlink contributed the highest exposure among all sources showing an increase in median exposure and overall exposure trend. Of seven micro-environment types, five of them showed total exposure levels (median and P99) and overall exposure trend increased at follow-up.


Subject(s)
Electromagnetic Fields , Environmental Exposure , Radio Waves , Electromagnetic Fields/adverse effects , Radio Waves/adverse effects , Humans , Longitudinal Studies , Victoria , Australia
2.
Occup Environ Med ; 80(3): 160-169, 2023 03.
Article in English | MEDLINE | ID: mdl-36720634

ABSTRACT

OBJECTIVES: To investigate mortality and the rates of incident cancer among a cohort of aluminium industry workers. METHODS: Among 4507 male employees who worked in either of two Australian prebake smelters for at least 3 months, data linkage was undertaken with the Australian National Death Index and Australian Cancer Database. Standardised Mortality Ratios (SMRs) and Standardised Incidence Rates (SIRs) were estimated for the whole cohort and for: production; maintenance and office workers. SMRs and SIRs were calculated by time since first employment. RESULTS: Among production workers, there was an excess risk of mortality from mesothelioma (SMR 2.8, 95% CI 1.3 to 5.2), lung (SMR 1.4, 95% CI 1.0 to 1.8), prostate (SMR 1.9, 95% CI 1.3 to 2.7) and liver cancer (SMR 2.0, 95% CI 1.1 to 3.4) and the SIR was also increased for overall respiratory cancers, specifically lung cancers. An excess risk of death from stomach cancer (SMR 2.9, 95% CI 1.2 to 6.1) and Alzheimer's disease (SMR 3.4, 95% CI 1.1 to 7.9) was seen among maintenance workers. The overall risk of death was similar to that of the Australian general population, as was mortality from cancers overall and non-malignant respiratory disease. CONCLUSIONS: No excess risk of death from bladder cancer or non-malignant respiratory disease was found. Excess lung cancer mortality and incidence may be explained by smoking and excess mortality from mesothelioma may be explained by asbestos exposure. An excess risk of mortality from liver and prostate cancer has been shown in production workers and requires further investigation.


Subject(s)
Lung Neoplasms , Mesothelioma, Malignant , Mesothelioma , Neoplasms , Occupational Diseases , Occupational Exposure , Humans , Male , Aluminum/adverse effects , Incidence , Cohort Studies , Occupational Diseases/etiology , Australia/epidemiology , Mesothelioma/etiology , Cause of Death , Mesothelioma, Malignant/complications , Occupational Exposure/adverse effects
3.
Occup Environ Med ; 80(4): 186-191, 2023 04.
Article in English | MEDLINE | ID: mdl-36754595

ABSTRACT

OBJECTIVES: Malignant mesothelioma is an uncommon cancer associated with asbestos exposure, predominantly occupational. Asbestos has been banned in Australia since 2003 but mesothelioma has a long latency and incident cases continue to present. The Australian Mesothelioma Registry was incepted to collect systematic data about incidence and mortality alongside asbestos exposure. METHODS: Benefiting from the Australian national system of cancer notification, all incident cases of mesothelioma in all states and territories are fast-tracked and notified regularly. Notified patients are contacted asking for consent to collect exposure information, initially by postal questionnaire and subsequently by telephone interview. Age-standardised annual incidence rates and mortality rates were calculated. Asbestos exposure was categorised as occupational, non-occupational, neither or, both; and as low, or high, probability of exposure. RESULTS: Mesothelioma incidence appears to have peaked. The age-standardised incidence rates have declined steadily since the early 2000s (peaking in males at 5.9/100 000 and in all-persons at 3.2/100 000), driven by rates in males, who comprise the majority of diagnosed cases. Rates in women have remained fairly stable since that time. Age-standardised mortality rates have followed similar trends. Mesothelioma remains the most common in those aged over 80 years. Nearly all (94%) cases were linked with asbestos exposure (78% occupational in men; 6.8% in women). CONCLUSIONS: With effective control of occupational asbestos use, the decline in age-standardised incidence and death rates has occurred. Incidence rates among women, in whom occupational asbestos exposure is rarely detectable, remain unchanged, pointing to the role of household and /or environmental asbestos exposure.


Subject(s)
Asbestos , Mesothelioma, Malignant , Mesothelioma , Occupational Exposure , Male , Humans , Female , Aged, 80 and over , Mesothelioma, Malignant/chemically induced , Mesothelioma, Malignant/complications , Incidence , Australia/epidemiology , Mesothelioma/etiology , Asbestos/adverse effects , Occupational Exposure/adverse effects , Registries
4.
Occup Environ Med ; 80(1): 51-60, 2023 01.
Article in English | MEDLINE | ID: mdl-36280382

ABSTRACT

OBJECTIVES: Adverse occupational exposures can accelerate age-related lung function decline. Some longitudinal population-based studies have investigated this association. This study aims to examine this association using findings reported by longitudinal population-based studies. METHODS: Ovid Medline, PubMed, Embase, and Web of Science were searched using keywords and text words related to occupational exposures and lung function and 12 longitudinal population-based studies were identified using predefined inclusion criteria. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Lung function decline was defined as annual loss of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) or the ratio (FEV1/FVC). Fixed and random-effects meta-analyses were conducted to calculate pooled estimates for ever and cumulative exposures. Heterogeneity was assessed using the I2 test, and publication bias was evaluated using funnel plots. RESULTS: Ever exposures to gases/fumes, vapours, gases, dusts, fumes (VGDF) and aromatic solvents were significantly associated with FEV1 decline in meta-analyses. Cumulative exposures for these three occupational agents observed a similar trend of FEV1 decline. Ever exposures to fungicides and cumulative exposures to biological dust, fungicides and insecticides were associated with FEV1 decline in fixed-effect models only. No statistically significant association was observed between mineral dust, herbicides and metals and FEV1 decline in meta-analyses. CONCLUSION: Pooled estimates from the longitudinal population-based studies have provided evidence that occupational exposures are associated with FEV1 decline. Specific exposure control and respiratory health surveillance are required to protect the lung health of the workers.


Subject(s)
Fungicides, Industrial , Occupational Exposure , Humans , Fungicides, Industrial/pharmacology , Occupational Exposure/adverse effects , Lung , Forced Expiratory Volume , Vital Capacity , Dust , Gases , Longitudinal Studies
5.
Occup Environ Med ; 80(10): 599-602, 2023 10.
Article in English | MEDLINE | ID: mdl-37722828

ABSTRACT

OBJECTIVES: We aimed to examine the relationship between occupational exposure to extremely low-frequency magnetic fields (ELF-MFs) and follicular lymphoma (FL) risk. METHODS: We conducted a family case-control study between 2011 and 2016 in Australia and included 681 cases. Controls were either a family member of cases (related (n=294), unrelated (n=179)) or were unrelated recruited for a similarly designed Australian multiple myeloma study (n=711). We obtained detailed job histories using lifetime work calendars. We assigned exposure to ELF-MFs using an enhanced job exposure matrix, with a lag period of 10 years. We examined associations with FL risk using logistic regression accounting for relatedness between cases and controls. We performed sensitivity analyses including by control type, by sex, complete case analyses, ELF-MF exposure percentiles in addition to quartiles, ELF-MF exposure in the maximum exposed job, a shorter lag period (1 year) and the cumulative exposure in the most recent time period (1-9 years). RESULTS: We observed no association with the average intensity, duration or lifetime cumulative exposure to occupational ELF-MF exposure in the primary or sensitivity analyses. CONCLUSIONS: Our findings do not support an association between occupational ELF-MF exposure and FL risk. Although the inclusion of family members as part of the larger control group may have biased our risk estimates towards the null, findings were similar in sensitivity analyses restricted to cases and unrelated controls. Further research incorporating enhanced exposure assessment to ELF-MF is warranted to inform occupational safety regulations and any potential role in lymphomagenesis.


Subject(s)
Lymphoma, Follicular , Occupational Exposure , Humans , Lymphoma, Follicular/epidemiology , Lymphoma, Follicular/etiology , Case-Control Studies , Risk Factors , Australia/epidemiology , Magnetic Fields , Occupational Exposure/adverse effects , Electromagnetic Fields/adverse effects
6.
Occup Environ Med ; 80(10): 564-571, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37797979

ABSTRACT

OBJECTIVES: There is a scarcity of evidence on occupational exposures that may increase eczema in adults. We aimed to investigate potential associations between occupational exposures and eczema in middle-aged adults. METHODS: A lifetime work history calendar was collected from the Tasmanian Longitudinal Health Study participants when they were at age 53. Their work history was collated with the occupational asthma-specific job exposure matrix to define ever-exposure and cumulative exposure unit-years since no eczema job exposure matrix is available. Eczema was determined using the report of flexural rash that was coming and going for at least 6 months in the last 12 months. Skin prick tests were used to further subgroup eczema and atopic eczema (AE) or non-AE (NAE). Logistic and multinomial regression models were used to investigate the associations. RESULTS: Eczema prevalence was 9.1%. Current occupational exposure to animals (adjusted OR, aOR=3.06 (95% CI 1.43 to 6.58)), storage mites (aOR=2.96 (95% CI 1.38 to 6.34)) and endotoxin (aOR=1.95 (95% CI 1.04 to 3.64)) were associated with increased risk of current eczema. Furthermore, increased odds of NAE were associated with current exposure to animals (aOR=5.60 (95% CI 1.45 to 21.7)) and storage mites (aOR=5.63 (95% CI 1.45 to 21.9)). Current exposures to isocyanates (aOR=5.27 (95% CI 1.17 to 23.7)) and acrylates (aOR=8.41 (95% CI 1.60 to 44.3)) were associated with AE. There was no evidence of associations between cumulative exposures and eczema prevalence. Cumulative exposure to metalworking fluids (aOR=1.10 (95% CI 1.01 to 1.22)) was associated with NAE and acrylates (aOR=1.24 (95% CI 1.04 to 1.46)) with AE. CONCLUSIONS: In this exploratory assessment, multiple occupational exposures were associated with current eczema in middle-aged adults. Raising awareness and limiting these exposures during an individual's productive working life will likely have various health benefits, including reducing eczema prevalence.


Subject(s)
Asthma, Occupational , Dermatitis, Atopic , Eczema , Occupational Exposure , Middle Aged , Animals , Humans , Adult , Dermatitis, Atopic/complications , Eczema/epidemiology , Eczema/etiology , Occupational Exposure/adverse effects , Allergens , Prevalence , Asthma, Occupational/epidemiology , Asthma, Occupational/etiology , Acrylates , Risk Factors
7.
Cancer Causes Control ; 33(5): 749-757, 2022 May.
Article in English | MEDLINE | ID: mdl-35184245

ABSTRACT

PURPOSE: High-grade disease accounts for ~ 70% of all glioma, and has a high mortality rate. Few modifiable exposures are known to be related to glioma risk or mortality. METHODS: We examined associations between lifetime physical activity and physical activity at different ages (15-18 years, 19-29 years, 30-39 years, last 10 years) with the risk of glioma diagnosis, using data from a hospital-based family case-control study (495 cases; 371 controls). We followed up cases over a median of 25 months to examine whether physical activity was associated with all-cause mortality. Physical activity and potential confounders were assessed by self-administered questionnaire. We examined associations between physical activity (metabolic equivalent [MET]-h/wk) and glioma risk using unconditional logistic regression and with all-cause mortality in cases using Cox regression. RESULTS: We noted a reduced risk of glioma for the highest (≥ 47 MET-h/wk) versus lowest (< 24 METh/wk) category of physical activity for lifetime activity (OR = 0.58, 95% CI: 0.38-0.89) and at 15-18 years (OR = 0.57, 95% CI: 0.39-0.83). We did not observe any association between physical activity and all-cause mortality (HR for lifetime physical activity = 0.91, 95% CI: 0.64-1.29). CONCLUSION: Our findings are consistent with previous research that suggested physical activity during adolescence might be protective against glioma. Engaging in physical activity during adolescence has many health benefits; this health behavior may also offer protection against glioma.


Subject(s)
Exercise , Glioma , Adolescent , Case-Control Studies , Follow-Up Studies , Glioma/epidemiology , Humans , Risk Factors
8.
Occup Environ Med ; 79(12): 795-806, 2022 12.
Article in English | MEDLINE | ID: mdl-36207110

ABSTRACT

OBJECTIVES: Given mixed evidence for carcinogenicity of current-use herbicides, we studied the relationship between occupational herbicide use and risk of non-Hodgkin's lymphoma (NHL) in a large, pooled study. METHODS: We pooled data from 10 case-control studies participating in the International Lymphoma Epidemiology Consortium, including 9229 cases and 9626 controls from North America, the European Union and Australia. Herbicide use was coded from self-report or by expert assessment in the individual studies, for herbicide groups (eg, phenoxy herbicides) and active ingredients (eg, 2,4-dichlorophenoxyacetic acid (2,4-D), glyphosate). The association between each herbicide and NHL risk was estimated using logistic regression to produce ORs and 95% CIs, with adjustment for sociodemographic factors, farming and other pesticides. RESULTS: We found no substantial association of all NHL risk with ever-use of any herbicide (OR=1.10, 95% CI: 0.94 to 1.29), nor with herbicide groups or active ingredients. Elevations in risk were observed for NHL subtypes with longer duration of phenoxy herbicide use, such as for any phenoxy herbicide with multiple myeloma (>25.5 years, OR=1.78, 95% CI: 0.74 to 4.27), 2,4-D with diffuse large B-cell lymphoma (>25.5 years, OR=1.47, 95% CI: 0.67 to 3.21) and other (non-2,4-D) phenoxy herbicides with T-cell lymphoma (>6 years, lagged 10 years, OR=3.24, 95% CI: 1.03 to 10.2). An association between glyphosate and follicular lymphoma (lagged 10 years: OR=1.48, 95% CI: 0.98 to 2.25) was fairly consistent across analyses. CONCLUSIONS: Most of the herbicides examined were not associated with NHL risk. However, associations of phenoxy herbicides and glyphosate with particular NHL subtypes underscore the importance of estimating subtype-specific risks.


Subject(s)
Herbicides , Lymphoma, Non-Hodgkin , Occupational Exposure , Pesticides , Humans , Herbicides/adverse effects , Occupational Exposure/adverse effects , Lymphoma, Non-Hodgkin/chemically induced , Lymphoma, Non-Hodgkin/epidemiology , Agriculture , Case-Control Studies , Risk Factors
9.
Int J Cancer ; 149(10): 1768-1786, 2021 11 15.
Article in English | MEDLINE | ID: mdl-34270795

ABSTRACT

Evidence for the human health effects of pesticides is needed to inform risk assessment. We studied the relationship between occupational insecticide use and risk of non-Hodgkin lymphoma (NHL) by pooling data from nine case-control studies participating in the InterLymph Consortium, including 7909 cases and 8644 controls from North America, the European Union and Australia. Insecticide use was coded using self-report or expert assessment, for insecticide groups (eg, organophosphates, pyrethroids) and active ingredients (eg, malathion, permethrin). Associations with insecticides were estimated using logistic regression to produce odds ratios (ORs) and 95% confidence intervals (CI) for all NHL and NHL subtypes, with adjustment for study site, demographic factors and use of other pesticides. Occupational insecticide use, overall, was not associated with risk of NHL. Use of organophosphate insecticides was associated with increased risk of all NHL and the subtype follicular lymphoma, and an association was found with diazinon, in particular (ever use: OR = 2.05, 95%CI: 1.24-3.37). The carbamate insecticide, carbaryl, was associated with risk of all NHL, and the strongest associations were found with T-cell NHL for ever-use (OR = 2.44, 95%CI: 1.13-5.28) and longer duration (>8 years vs never: OR = 2.90, 95%CI: 1.02-8.25). There was no association of NHL with other broad groups of insecticides, including organochlorines and pyrethroids, and some inverse associations were estimated in relation to historical DDT use. Our findings contribute to the totality of evidence available to help inform risk decisions by public health and regulatory agencies of importance given continued, widespread use of organophosphate and carbamate insecticides.


Subject(s)
Insecticides/poisoning , Lymphoma, Non-Hodgkin/diagnosis , Occupational Diseases/diagnosis , Occupational Exposure/adverse effects , Occupational Health/statistics & numerical data , Adult , Aged , Australia , Case-Control Studies , European Union , Female , Humans , Lymphoma, Non-Hodgkin/etiology , Lymphoma, Non-Hodgkin/prevention & control , Male , Middle Aged , North America , Occupational Diseases/etiology , Occupational Diseases/prevention & control , Occupational Exposure/analysis , Odds Ratio , Risk Assessment/methods , Risk Assessment/statistics & numerical data , Risk Factors
10.
Environ Res ; 197: 110887, 2021 06.
Article in English | MEDLINE | ID: mdl-33607095

ABSTRACT

BACKGROUND: The etiology of follicular lymphoma (FL), a common non-Hodgkin lymphoma subtype, is largely unknown. OBJECTIVE: We performed a systematic review and meta-analysis of observational studies examining the relationship between occupational exposures and FL risk. METHODS: We searched Ovid MEDLINE, Ovid EMBASE, and Web of Science for eligible observational studies examining job titles or occupational exposures prior to January 1, 2020. We performed a narrative synthesis and used random-effects models to generate meta-estimates of relative risk (RR) with 95% confidence intervals (95%CI) for exposures reported by three or more studies. RESULTS: Fifty-eight studies were eligible. Ten cohort and 37 case-control studies quantified FL risk in relation to any exposure to one or more occupational groups or agents. Eight cohort and 19 case-control studies examined dose-response relationships. We found evidence of a positive association with increasing plasma concentration of dichlorodiphenyldichloroethylene (DDE; meta-RR = 1.51, 95%CI = 0.99, 2.31; I2 = 0.0%) and polychlorinated biphenyls (PCBs; meta-RR = 1.47, 95%CI = 0.97, 2.24; I2 = 8.6%). We observed a positive association with exposure to any solvent (meta-RR = 1.16, 95%CI = 1.00, 1.34; I2 = 0.0%) and chlorinated solvents (meta-RR = 1.35, 95%CI = 1.09, 1.68; I2 = 0.0%). Single studies reported a significant positive dose-response association for exposure to any pesticide, hexachlorobenzene, any organophosphate, diazinon, metolachlor, carbaryl, lindane, trichloroethylene, oils/greases, and extremely low-frequency magnetic fields. Job title-only analyses suggested increased risk for medical doctors and spray painters, and decreased risk for bakers and teachers. Overall, studies demonstrated low risk of bias, but most studies examined small numbers of exposed cases. CONCLUSIONS: Current evidence indicates a positive association between FL and occupational exposure to DDE, PCBs, any solvent and chlorinated solvents. Our findings may help guide policies and practices on the safe use of solvents and inform models of lymphomagenesis. Future studies with larger sample sizes and comprehensive quantitative exposure measures may elucidate other avoidable carcinogenic exposures.


Subject(s)
Lymphoma, Follicular , Lymphoma, Non-Hodgkin , Occupational Exposure , Cohort Studies , Humans , Lymphoma, Follicular/chemically induced , Lymphoma, Follicular/epidemiology , Lymphoma, Non-Hodgkin/chemically induced , Lymphoma, Non-Hodgkin/epidemiology , Occupational Exposure/adverse effects , Solvents
11.
Thorax ; 75(10): 864-869, 2020 10.
Article in English | MEDLINE | ID: mdl-32660982

ABSTRACT

INTRODUCTION: Idiopathic pulmonary fibrosis (IPF) is a lung disease of unknown cause characterised by progressive scarring, with limited effective treatment and a median survival of only 2-3 years. Our aim was to identify potential occupational and environmental exposures associated with IPF in Australia. METHODS: Cases were recruited by the Australian IPF registry. Population-based controls were recruited by random digit dialling, frequency matched on age, sex and state. Participants completed a questionnaire on demographics, smoking, family history, environmental and occupational exposures. Occupational exposure assessment was undertaken with the Finnish Job Exposure Matrix and Australian asbestos JEM. Multivariable logistic regression was used to describe associations with IPF as ORs and 95% CIs, adjusted for age, sex, state and smoking. RESULTS: We recruited 503 cases (mean±SD age 71±9 years, 69% male) and 902 controls (71±8 years, 69% male). Ever smoking tobacco was associated with increased risk of IPF: OR 2.20 (95% CI 1.74 to 2.79), but ever using marijuana with reduced risk after adjusting for tobacco: 0.51 (0.33 to 0.78). A family history of pulmonary fibrosis was associated with 12.6-fold (6.52 to 24.2) increased risk of IPF. Occupational exposures to secondhand smoke (OR 2.1; 1.2 to 3.7), respirable dust (OR 1.38; 1.04 to 1.82) and asbestos (OR 1.57; 1.15 to 2.15) were independently associated with increased risk of IPF. However occupational exposures to other specific organic, mineral or metal dusts were not associated with IPF. CONCLUSION: The burden of IPF could be reduced by intensified tobacco control, occupational dust control measures and elimination of asbestos at work.


Subject(s)
Environmental Exposure/adverse effects , Idiopathic Pulmonary Fibrosis/diagnosis , Idiopathic Pulmonary Fibrosis/epidemiology , Occupational Diseases/diagnosis , Occupational Diseases/epidemiology , Occupational Exposure/adverse effects , Aged , Australia , Case-Control Studies , Dust , Female , Humans , Male , Metals , Risk Factors
12.
Am J Ind Med ; 63(12): 1116-1123, 2020 12.
Article in English | MEDLINE | ID: mdl-32944994

ABSTRACT

BACKGROUND: Information is scarce about the occupational health effects of exposure to alumina dust. This study examines the respiratory effects of inspirable alumina dust exposure in alumina refineries. METHODS: An inception cohort study at three alumina refineries in Western Australia recruited 416 participants (351 males, 65 females) between 1995 and 2000 who were followed up annually until 2008 or until exit from study. At each health interview a respiratory questionnaire and lung function test was undertaken, measuring forced expiratory volume in one second (FEV1 ) and forced vital capacity (FVC). Participants provided job histories which were combined with air monitoring data to calculate cumulative exposure to inspirable alumina dust (mg/m3 -years). Generalized estimating equations with Poisson distribution and mixed effects models were used to examine the effects of alumina exposure. RESULTS: The number of exposed participants was relatively small (n = 82, 19.7%). There was no association between alumina dust exposure and prevalence of cough, wheeze or rhinitis. No associations were found between measures of lung function and tertiles of alumina exposure in the first two follow-ups, or the whole follow-up period, though there was a suggestive dose-response trend across exposed groups for decline in absolute FEV1 (p for trend = .06). For mean annual change in FEV1 and FVC based on the first three follow-ups it was not possible to rule out an effect above a threshold level of exposure. CONCLUSION: There is no evidence of an association between exposure to alumina and the reporting of respiratory symptoms but some evidence for an effect on lung function.


Subject(s)
Air Pollutants, Occupational/toxicity , Aluminum Oxide/toxicity , Inhalation Exposure/adverse effects , Lung Diseases/epidemiology , Occupational Diseases/epidemiology , Occupational Exposure/adverse effects , Adult , Cough/epidemiology , Cough/etiology , Dust , Extraction and Processing Industry , Female , Humans , Longitudinal Studies , Lung Diseases/etiology , Male , Occupational Diseases/etiology , Prevalence , Respiratory Function Tests , Respiratory Sounds/etiology , Rhinitis/epidemiology , Rhinitis/etiology , Skin Tests , Western Australia/epidemiology
14.
Thorax ; 74(7): 650-658, 2019 07.
Article in English | MEDLINE | ID: mdl-31028237

ABSTRACT

RATIONALE: While cross-sectional studies have shown associations between certain occupational exposures and lower levels of lung function, there was little evidence from population-based studies with repeated lung function measurements. OBJECTIVES: We aimed to investigate the associations between occupational exposures and longitudinal lung function decline in the population-based Tasmanian Longitudinal Health Study. METHODS: Lung function decline between ages 45 years and 50 years was assessed using data from 767 participants. Using lifetime work history calendars completed at age 45 years, exposures were assigned according to the ALOHA plus Job Exposure Matrix. Occupational exposures were defined as ever exposed and cumulative exposure -unit- years. We investigated effect modification by sex, smoking and asthma status. RESULTS: Compared with those without exposure, ever exposures to aromatic solvents and metals were associated with a greater decline in FEV1 (aromatic solvents 15.5 mL/year (95% CI -24.8 to 6.3); metals 11.3 mL/year (95% CI -21.9 to - 0.7)) and FVC (aromatic solvents 14.1 mL/year 95% CI -28.8 to - 0.7; metals 17.5 mL/year (95% CI -34.3 to - 0.8)). Cumulative exposure (unit years) to aromatic solvents was also associated with greater decline in FEV1 and FVC. Women had lower cumulative exposure years to aromatic solvents than men (mean (SD) 9.6 (15.5) vs 16.6 (14.6)), but greater lung function decline than men. We also found association between ever exposures to gases/fumes or mineral dust and greater decline in lung function. CONCLUSIONS: Exposures to aromatic solvents and metals were associated with greater lung function decline. The effect of aromatic solvents was strongest in women. Preventive strategies should be implemented to reduce these exposures in the workplace.


Subject(s)
Lung/drug effects , Lung/physiopathology , Occupational Exposure/adverse effects , Solvents/adverse effects , Adult , Aging/physiology , Female , Forced Expiratory Volume/drug effects , Forced Expiratory Volume/physiology , Health Surveys , Humans , Longitudinal Studies , Male , Middle Aged , Occupational Exposure/analysis , Sex Factors , Solvents/analysis , Vital Capacity/drug effects , Vital Capacity/physiology
15.
Respir Res ; 20(1): 33, 2019 Feb 14.
Article in English | MEDLINE | ID: mdl-30764884

ABSTRACT

BACKGROUND: Early life exposure to tobacco smoke has been extensively studied but the role of second-hand smoke (SHS) for new-onset respiratory symptoms and lung function decline in adulthood has not been widely investigated in longitudinal studies. Our aim is to investigate the associations of exposure to SHS in adults with respiratory symptoms, respiratory conditions and lung function over 20 years. METHODS: We used information from 3011 adults from 26 centres in 12 countries who participated in the European Community Respiratory Health Surveys I-III and were never or former smokers at all three surveys. Associations of SHS exposure with respiratory health (asthma symptom score, asthma, chronic bronchitis, COPD) were analysed using generalised linear mixed-effects models adjusted for confounding factors (including sex, age, smoking status, socioeconomic status and allergic sensitisation). Linear mixed-effects models with additional adjustment for height were used to assess the relationships between SHS exposure and lung function levels and decline. RESULTS: Reported exposure to SHS decreased in all 26 study centres over time. The prevalence of SHS exposure was 38.7% at baseline (1990-1994) and 7.1% after the 20-year follow-up (2008-2011). On average 2.4% of the study participants were not exposed at the first, but were exposed at the third examination. An increase in SHS exposure over time was associated with doctor-diagnosed asthma (odds ratio (OR): 2.7; 95% confidence interval (95%-CI): 1.2-5.9), chronic bronchitis (OR: 4.8; 95%-CI: 1.6-15.0), asthma symptom score (count ratio (CR): 1.9; 95%-CI: 1.2-2.9) and dyspnoea (OR: 2.7; 95%-CI: 1.1-6.7) compared to never exposed to SHS. Associations between increase in SHS exposure and incidence of COPD (OR: 2.0; 95%-CI: 0.6-6.0) or lung function (ß: - 49 ml; 95%-CI: -132, 35 for FEV1 and ß: - 62 ml; 95%-CI: -165, 40 for FVC) were not apparent. CONCLUSION: Exposure to second-hand smoke may lead to respiratory symptoms, but this is not accompanied by lung function changes.


Subject(s)
Health Status , Respiratory System/physiopathology , Tobacco Smoke Pollution/adverse effects , Adult , Asthma/epidemiology , Asthma/etiology , Bronchitis, Chronic/epidemiology , Bronchitis, Chronic/etiology , Dyspnea/epidemiology , Dyspnea/etiology , Europe/epidemiology , European Union , Follow-Up Studies , Health Surveys , Humans , Incidence , Prevalence , Respiratory Function Tests , Respiratory Tract Diseases/epidemiology , Respiratory Tract Diseases/etiology , Socioeconomic Factors , Tobacco Smoke Pollution/statistics & numerical data
16.
Occup Environ Med ; 76(4): 222-229, 2019 04.
Article in English | MEDLINE | ID: mdl-30700596

ABSTRACT

OBJECTIVES: Chronic bronchitis (CB) is an important chronic obstructive pulmonary disease (COPD)-related phenotype, with distinct clinical features and prognostic implications. Occupational exposures have been previously associated with increased risk of CB but few studies have examined this association prospectively using objective exposure assessment. We examined the effect of occupational exposures on CB incidence in the European Community Respiratory Health Survey. METHODS: Population samples aged 20-44 were randomly selected in 1991-1993, and followed up twice over 20 years. Participants without chronic cough or phlegm at baseline were analysed. Coded job histories during follow-up were linked to the ALOHA Job Exposure Matrix, generating occupational exposure estimates to 12 categories of chemical agents. Their association with CB incidence over both follow-ups was examined with Poisson models using generalised estimating equations. RESULTS: 8794 participants fulfilled the inclusion criteria, contributing 13 185 observations. Only participants exposed to metals had a higher incidence of CB (relative risk (RR) 1.70, 95% CI 1.16 to 2.50) compared with non-exposed to metals. Mineral dust exposure increased the incidence of chronic phlegm (RR 1.72, 95% CI 1.43 to 2.06). Incidence of chronic phlegm was increased in men exposed to gases/fumes and to solvents and in women exposed to pesticides. CONCLUSIONS: Occupational exposures are associated with chronic phlegm and CB, and the evidence is strongest for metals and mineral dust exposure. The observed differences between men and women warrant further investigation.


Subject(s)
Bronchitis, Chronic/etiology , Incidence , Occupational Exposure/adverse effects , Adult , Australia/epidemiology , Bronchitis, Chronic/complications , Bronchitis, Chronic/epidemiology , Cough/epidemiology , Cough/etiology , Dust , Europe/epidemiology , Female , Gases/adverse effects , Health Surveys , Humans , Longitudinal Studies , Male , Middle Aged , Occupational Exposure/statistics & numerical data , Pesticides/adverse effects , Risk Factors , Smoking/adverse effects , Smoking/epidemiology , United States/epidemiology
17.
Environ Res ; 170: 493-499, 2019 03.
Article in English | MEDLINE | ID: mdl-30690250

ABSTRACT

BACKGROUND: Exposure to far-field radiofrequency electromagnetic fields (RF-EMF) has raised public concerns in recent decades. However, it is not known if individuals' perception towards the health risks of RF-EMF is dependent on their knowledge of the objectively measured personal RF-EMF exposure levels. OBJECTIVES: This pilot study aimed to demonstrate the feasibility of objectively measuring personal RF-EMF exposure from mobile phone base stations (MPBS) and to determine if the risk perception of people to the potential health risk of exposure to RF-EMF from MPBS is dependent on their knowledge of personal RF-EMF exposure levels. DESIGN: An experimental study was conducted in 383 adults, recruited in Melbourne, Australia. Participants were randomized to one of the three groups: 1) basic information group who were provided with basic information about RF-EMF to read prior to completing a risk perception assessment questionnaire; 2) precautionary group who were provided with an information pack which included precautionary messages; and 3) personal exposure measurement group who were provided with a summary of their quantitative RF-EMF exposure from MPBS. The same basic information about RF-EMF was also given to the precautionary and personal exposure measurement groups. RESULTS: Participants had a mean (±â€¯SD) age of 36.9 ±â€¯12.5 years; 66.7% were women. Overall, 44.1% had noticed an MPBS in their neighbourhood. The mean (SD) values (from 1 to 7) for risk perceptions to RF-EMF from MPBS were 4.02 (1.67) for basic information, 3.82 (1.62) for precautionary messages, and 3.97 (1.72) for the personal exposure measurement groups. These differences were not statistically significant. Nevertheless, the personal exposure measurement group were more confident that they could protect themselves from RF-EMF than the precautionary or basic information groups. CONCLUSION: Our findings suggest that providing people with personal RF-EMF exposure measurements may not affect their perceived risk from MPBS, but increase their confidence in protecting themselves.


Subject(s)
Cell Phone , Electromagnetic Fields , Environmental Exposure/statistics & numerical data , Adult , Australia , Female , Humans , Male , Perception , Pilot Projects , Radio Waves
18.
Indoor Air ; 29(4): 670-679, 2019 07.
Article in English | MEDLINE | ID: mdl-30963644

ABSTRACT

This longitudinal study investigated whether smoking bans influence passive smoking at work and/or at home in the same subjects. Passive smoking at work and/or at home was investigated in random population samples (European Community Respiratory Health Survey) in 1990-1995, with follow-up interviews in 1998-2003 and 2010-2014. National smoking bans were classified as partial (restricted to public workplaces) or global (extended to private workplaces). Multivariable analysis was accomplished by three-level logistic regression models, where level-1, level-2, and level-3 units were, respectively, questionnaire responses, subjects, and centers. Passive smoking at work was reported by 31.9% in 1990-1995, 17.5% in 1998-2003, and 2.5% in 2010-2014. Concurrently, passive smoking at home decreased from 28.9% to 18.2% and 8.8%. When controlling for sex, age, education, smoking status, and ECHRS wave, the odds of passive smoking at work was markedly reduced after global smoking bans (OR = 0.45, 95% CI 0.25-0.81), particularly among non-smokers, while the protective effect of global smoking bans on passive smoking at home was only detected in non-smokers. Smoking bans both in public and private workplaces were effective in reducing passive smoking at work in Europe. However, given the inefficacy of smoking bans in current smokers' dwellings, better strategies are needed to avoid smoking indoors.


Subject(s)
Smoke-Free Policy , Smoking Prevention/methods , Smoking/epidemiology , Tobacco Smoke Pollution/statistics & numerical data , Adult , Europe/epidemiology , Female , Health Surveys , Housing , Humans , Logistic Models , Longitudinal Studies , Male , Middle Aged , Tobacco Smoke Pollution/analysis , Tobacco Smoke Pollution/prevention & control , United Kingdom/epidemiology , Workplace , Young Adult
19.
Thorax ; 73(11): 1008-1015, 2018 11.
Article in English | MEDLINE | ID: mdl-29574416

ABSTRACT

BACKGROUND: Occupational exposures have been associated with an increased risk of COPD. However, few studies have related objectively assessed occupational exposures to prospectively assessed incidence of COPD, using postbronchodilator lung function tests. Our objective was to examine the effect of occupational exposures on COPD incidence in the European Community Respiratory Health Survey. METHODS: General population samples aged 20-44 were randomly selected in 1991-1993 and followed up 20 years later (2010-2012). Spirometry was performed at baseline and at follow-up, with incident COPD defined using a lower limit of normal criterion for postbronchodilator FEV1/FVC. Only participants without COPD and without current asthma at baseline were included. Coded job histories during follow-up were linked to a Job-Exposure Matrix, generating occupational exposure estimates to 12 categories of agents. Their association with COPD incidence was examined in log-binomial models fitted in a Bayesian framework. FINDINGS: 3343 participants fulfilled the inclusion criteria; 89 of them had COPD at follow-up (1.4 cases/1000 person-years). Participants exposed to biological dust had a higher incidence of COPD compared with those unexposed (relative risk (RR) 1.6, 95% CI 1.1 to 2.3), as did those exposed to gases and fumes (RR 1.5, 95% CI 1.0 to 2.2) and pesticides (RR 2.2, 95% CI 1.1 to 3.8). The combined population attributable fraction for these exposures was 21.0%. INTERPRETATION: These results substantially strengthen the evidence base for occupational exposures as an important risk factor for COPD.


Subject(s)
Forecasting , Health Surveys/methods , Occupational Diseases/complications , Occupational Exposure/adverse effects , Pulmonary Disease, Chronic Obstructive/epidemiology , Adult , Australia/epidemiology , Europe/epidemiology , Female , Follow-Up Studies , Humans , Incidence , Male , Occupational Diseases/epidemiology , Pulmonary Disease, Chronic Obstructive/etiology , Respiratory Function Tests , Retrospective Studies , Risk Factors , Young Adult
20.
J Asthma ; 55(9): 994-1001, 2018 09.
Article in English | MEDLINE | ID: mdl-28976229

ABSTRACT

OBJECTIVE: Atopy is associated with asthma, but cross-sectional studies suggest this association may be weaker in older adults. It remains unclear if atopy predicts asthma later in adult life. We aimed to investigate whether atopy in young adults predicted asthma 20 years later and to quantify the contemporaneous relationship of atopy and asthma as adults age. METHODS: Participants of the European Community Respiratory Health Survey (ECRHS) in Melbourne aged 20-44 years were followed for 20 years and completed questionnaires, skin prick tests (SPT) and allergen specific immunoglobulin E measurement at a baseline and two subsequent surveys. Using logistic regression and generalized estimating equations, we tested if atopy at baseline predicted current asthma later in life and estimated the association between current atopy measured at each survey and current asthma, while adjusting for potential confounders. RESULTS: The analysis included 220 participants: 50.9% male. Mean (SD) age at baseline was 35.7 (5.7) years. Asthma and atopy prevalence remained stable over 20 years. Baseline atopy (SPT) was associated with current asthma (OR 9.74, 95%CI 4.22, 22.5) over 20 years, and current atopy (SPT) with concurrent asthma (3.12; 1.70, 5.74). CONCLUSIONS: Atopy remains strongly associated with current asthma in 40 to 64 year-old adults, both prospectively and contemporaneously, but the prospective association is stronger.


Subject(s)
Aging/physiology , Asthma/epidemiology , Hypersensitivity, Immediate/epidemiology , Adult , Australia/epidemiology , Female , Follow-Up Studies , Health Surveys , Humans , Immunoglobulin E/blood , Intradermal Tests , Logistic Models , Male , Middle Aged , Prospective Studies , Young Adult
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